关键词: 低血压, 血液透析液, 强心药

Abstract: Objective　To investigate the clinical efficacy of meglumine adenosine cyclophosphate（MAC） combined with low temperature adjustable sodium hemodialysis（LSHD） for intradialytic hypotension（IDH）．Methods　We enrolled 28 patients with recurrent IDH who were admitted to the Blood Purification Center，Affiliated Hospital of Xuzhou Medical University and the Third Affiliated Hospital of Xuzhou Medical University from June to December 2015 and who met the inclusion criteria.All patients underwent either conventional hemodialysis（CHD），LSHD，or MAC combined with LSHD（M-LSHD） three times a week for 8 weeks，respectively.Changes in blood pressure and the incidence of hypotension were recorded during hemodialysis.Electrolyte（K+，Na+，Ca2+），serum urea nitrogen，serum creatinine，and N-terminal pro-brain natriuretic peptide（NT-proBNP） levels were also measured，and adverse effects were observed before and after the final hemodialysis for each treatment.Results　There was no significant difference in systolic or diastolic blood pressure prior to hemodialysis among the three treatments（P>0.05）．The lowest systolic and diastolic blood pressures during hemodialysis were significantly greater and the incidence of hypotension was significantly lower in patients undergoing M-LSHD compared with CHD or LSHD（P<0.05）．There were no significant differences in serum K+，Na+，Ca2+，urea nitrogen，or creatinine levels between before and after the final hemodialysis for each treatment（P>0.05），but NT-proBNP levels were significantly lower in patients undergoing M-LSHD compared with the other procedures both before and after hemodialysis（P<0.05）．In addition，no patients showed intolerance to low temperature，such as by chilling or shivering，and no palpitation or dizziness occurred following intravenous injection of MCA.Conclusion　M-LSHD may reduce the incidence of IDH by improving cardiac function in hemodialysis patients，with no apparent adverse reactions.These results have important clinical implications.

Key words: Hypotension, Hemodialysis solutions, Cardiotonic agent